15/12/2025
Waking Up with a Stiff Neck (Wry Neck)
When neck muscles work hard all day, but get placed in the wrong position at night.
"Wry neck" (or waking up with a stiff neck) is one of the most common issues massage therapists see. You wake up unable to turn your head, feeling a sharp pain like something is pulling from the inside. For some, the pain spreads to the shoulder blade; for others, the neck feels completely locked.
Many people think it’s just caused by the pillow.
But from a therapist’s perspective, this usually starts with muscles that have accumulated fatigue all day and didn't get to rest in the right angle.
This post explains in "muscle language" how wry neck happens and why it locks up so suddenly when you wake up.
1) Daytime: Muscles work hard, but they keep going.
All day long, your neck, shoulder, and scapula muscles work continuously—looking down at phones, sitting at computers, driving, or turning repeatedly in unbalanced ways.
You might not feel pain yet, but the muscles are silently accumulating fatigue. It’s like an engine that’s still running but starting to overheat.
2) Nighttime: Time to rest, but placed at the wrong angle.
Sleep is when muscles should recover. However, if your pillow or sleeping position is slightly off, that accumulated fatigue becomes an immediate problem.
• Pillow too high: Neck is cranked forward.
• Pillow too low: Neck droops down.
• Side sleeping: Neck is tilted.
• Stomach sleeping: Neck is twisted all night.
The result? Muscles that were supposed to relax end up being stretched or twisted for hours without you realizing it.
3) During Sleep: Muscles tense up all night.
Your muscles react automatically to support your head and neck.
• Levator Scapulae: Shortens immediately when stretched too long.
• Upper Trapezius: Hardens to support the neck.
• Rhomboids: Tighten and pull the shoulder blade up, dragging the neck with it.
• Occipitals (Base of skull): Tense up to balance the head.
All of this happens while you sleep. It’s like your muscles are working overtime all night without any actual rest. This is why wry neck often comes with "stuck shoulder blades" (scapula issues).
4) Morning: The muscles choose to "Lock Down."
When you wake up, you can’t turn your head. You feel deep, sharp pain, heavy shoulders, and a locked neck.
What’s happening isn't just about the pillow—it is the muscles locking themselves to prevent further injury. The pain is real, even if the structure isn't actually broken.
5) Therapist’s Language: Where we focus.
A stiff neck rarely comes alone. It usually involves a network of muscles:
• Levator scapulae
• Upper trapezius
• Rhomboids
• Occipital muscles
Since they are all connected, release work must be done in a specific sequence. We cannot rush or press too hard immediately, because if we force it, the muscles will fight back and tense up even more.
In Summary:
• Daytime: Neck muscles work hard and build up fatigue.
• Nighttime: Placed on a pillow at the wrong angle, causing tension.
• Morning: Muscles lock up for protection → resulting in a stiff neck (often linked to shoulder blade issues).
And so, the cycle continues in the same muscle groups.
